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Undergraduate Research Honors Ethical Issues and Life Choices (PHI2630)

2013 The Ethics of Embryonic Stem Cell Research Ariana von Lersner

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Ariana von Lersner

The Ethics of Embryonic Stem Cell Research

Keywords: ethics, abortion, stem cell research, embryonic

Abstract: Embryonic stem cell research involves the destruction of an embryo after

stem cells are extracted. The ethical considerations of destroying an embryo results

in a controversy where proponents of the research are pitted against pro life

supporters who abhor the destruction of the embryo as immoral. This paper

addresses the objections to embryonic stem cell research, similar to those against

abortion, which are rooted in the belief that it is morally impermissible to

intentionally take the life of an innocent human being. The counterargument is

presented such that the use of embryonic stem cells in research does not represent

the death of a human being; instead it provides valuable life saving medical

breakthroughs, and thus is a morally permissible use of discarded embryos. This

paper contributes to the defense of stem cell research by highlighting scientific

reasons why it is ethically permissible. It makes a clear distinction between the

definition of a human being and that of an embryo used in stem cell research.

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Embryonic stem cell research has been a controversial issue in the United States since the late nineties when the first human embryonic stem cells were cultured in a laboratory setting. The controversy has produced a moral divide, which involves significant differences of opinion from ethical, legal, and social standpoints. The debate is centered primarily on the use and destruction of human embryos during scientific research endeavors. In many instances, the debate pits the sanctity of one potential new life against the desire to improve the quality and longevity of numerous lives.

Responsible embryonic stem cell research is ethically permissible and should be conducted to achieve significant medical breakthroughs and to treat a vast number of diseases.

I. Stem Cell Basics

An understanding of the types, characteristics, and important benefits of stem cells aids in understanding the ethical and social considerations of this controversy. There are two main types of stem cells. One type, embryonic, uses the undifferentiated cells of an early human embryo to create any new, specialized type of cell (Brignier and Gewirtz

S337). Embryonic stem cells are very useful for cell based therapies because they can develop into more than 220 cell types that are found in an adult, and they have the ability to reproduce in large numbers. They are capable of almost unlimited cell divisions when placed in culture. This makes embryonic stem cells very flexible and versatile. Using stem cells to learn about the ways that these cells differentiate, grow, and renew will also have profound results in the study and cure of cancers, birth defects, diabetes, spinal cord injuries, and other diseases caused by dysfunctional cell replication. Research on 3 embryonic stem cells can also improve drug safety, as a drug can be tested on a stem cell line before use in a patient (Louis 2009). The embryonic stem cells are extracted from the inner cell mass during the early blastocyst phase of embryonic development. After an egg is fertilized, generally during in vitro in the laboratory, it begins dividing. The blastocyst is a hollow ball of about 150 cells. The inner cell mass are the cells located in the inner part of the ball, and once extracted, the embryo is no longer viable or living

(Monk 35). Hence, the controversy arises with destruction of the embryo.

The use of the other type of stem cells, adult stem cells, in research and treatments does not destroy an embryo. But adult stem cell applications have limitations, as will be noted. Research and therapies involving adult stem cells use specialized cells found in adults in areas such as the brain or bone marrow, and are able to self renew and generate into the same type of differentiated cells from which they originated (Brignier and

Gewirtz S336). Adult stem cells are responsible for repairing and replenishing cells within and throughout the body (Monk 35). However, isolating stem cells from adult tissue is very difficult (Louis 2009).

The main difference between embryonic and adult stem cells is their totipotency, or ability to form into a whole new cell. Embryonic stem cells can theoretically develop into any new type of cell, such as cardiac, lung, muscle and nerve cells. This ability is categorized as pluripotent. Adult stem cells can only develop into the same type of cell from which they were taken. For example, if adult stem cells were extracted from bone marrow, they could potentially grow into new bone marrow. This ability is categorized as multipotent (Brignier and Gewirtz S336). The potential to treat a great number of diseases with adult stem cells is lower than embryonic, because adult stem cells are 4 not able to differentiate into as many different types of cells as can embryonic stem cells. Adult stem cells have a much higher chance of having already developed genetic abnormalities over the course of time, which also limits their potential use in medical therapies (Louis 2009). One advantage of using adult stem cells is that a patient's own cells are transplanted back into the patient, which eliminates rejection of the cells and the need for immune suppressing drugs to counter rejection of new cells. With the use of embryonic stem cells, strong immune suppressing drugs may be indicated to ward off rejection of the new cells (Louis 2009). Not only do the two types of stem cells differ in their totipotency, but they also differ in their ability to be cultured. Embryonic stem cells can be grown relatively easily out of the body, whereas adult stem cells do not facilitate easy replication. More research needs to be done on adult stem cells to study and reproduce the conditions in which they will grow more readily in cell culture (Louis 2009). The fundamental differences between adult stem cells and embryonic stem cells give rise to the ethical controversy over using embryonic stem cells in research.

II. Objection: Controversy over Embryo Destruction

Most of the objections concerning embryonic stem cell research are rooted in the fact that the embryo is destroyed after the stem cells are extracted. Religious leaders, politicians, scientists and the public can have severe differences of opinion. Embryonic stem cell research brings up the complicated dilemma of whether the destruction of the embryo is unethical, as it involves the issue of whether or not the embryo has the right to its life, similar to the questions raised in matters of abortion (Robertson 192). The dilemma also sheds some light on fertility clinics for staunch opponents of stem cell 5

research. It brings up the question of whether the practice of in vitro fertilization should

be directly linked (and therefore banned) to the consequences of embryonic stem cell

extraction. The case is made that in vitro fertilization eventually leads to the discard of

embryos, which then leads to extraction of stem cells and then ultimately leads to the

death of the embryo (Curzer 534). The pro-life faction sees similarities between abortion

of a fetus and the destruction of an embryo for use in stem cell research, both

representing death of a human being.

To some opponents of stem cell research, the destruction of an embryo means that a

potential fetus and ultimately a potential human being were killed; therefore this act and

the research effort behind it is unethical and immoral. The basic argument is that an

embryo is a potential fetus and is an innocent human being. The moral premise in the

United States and most of the world is that it is morally impermissible to intentionally

take the life of an innocent human being (Siegel 2013). Therefore opponents of stem

cell research would say that it follows that it is morally impermissible to

intentionally kill the human embryo, as well as engage in embryonic stem cell research.

III. Counterargument: Use of Embryo is not Death of a Human

Supporters of embryonic stem cell research argue that most of the current stem cell research should not be labeled as impermissible, as most of the scientists involved are engaged in research that uses cell lines from previous derivations and extractions of stem cells. Most of the research done cannot be labeled as immoral, as the majority of researchers were not involved with destruction of the embryos

(Siegel 2013). Much of the current research effort is concentrated on the existing 6 cell lines from previous extractions, rather than requiring new embryos or the destruction of new embryos.

As to the argument that an embryo is a human being, opponents of embryonic stem cell research would say that a human being begins life at the point of a one‐cell zygote at fertilization. This has certainly been contested on both sides of the "when does life begin" debate. Recall that the embryo is in the blastocyst stage of human development, where it may be made up of about 150 or so cells. There is no human form yet, so there are no appendages, no organs, and no nervous system. The embryo is not mature enough to have these features because organogenesis, or the development of organs, has not occurred; consequently, it is just a mass of cells. Since organogenesis has not taken place, the development of the nervous system has not happened (Greene and

Copp 303). This is important to proponents of embryonic stem cell research, because with the development of a nervous system in humans comes the ability to feel pain and suffer. Supporters of embryonic stem cell research would argue that because no nervous system is present in the blastocyst stage, the early embryo is not a conscious being and cannot perceive or feel things (Mellor and Diesch 50). Therefore, the embryo should not be given human status as a conscious being.

There is also other basis for rejecting the idea that the early human embryo is a human being. For example, the cells that make up the early embryo are a bundle of homogeneous cells that might be contained in the same membrane but do not form a human being or human organism because the cells do not yet function in a way that would control or sustain a single life (Siegel 2013). The cells may be considered alive, but they do not become parts of a human organism until significant cell 7

differentiation and coordination occurs around day‐16 after fertilization. This argument maintains that using the cells of the 5‐day embryo to derive embryonic stem cells used in research does not involve the morally impermissible destruction of a human being (Greene and Copp 303). Those that oppose embryonic stem cell research argue that embryos are part of the human race and that all human beings have the same moral status at all stages of their lives; thus making it immoral to destroy human beings at any stage of their life.

Supporters of abortion as well as embryonic stem cell research indicate that the difference between the stages lies with capacity and potential. The individual may not have reached their full potential at their current stage (Siegel 2013). For

example, there are different mental capacities of an embryo versus a fetus versus a

child. There is a spectrum of mental capacity depending on the stage of

development. Opponents of stem cell research would say that no matter what the

stage of development, the "individual" needs to be treated with moral respect. One should not respect an adult while withholding moral respect to an embryo just because it has not reached full potential. The counterargument to this idea of potential is that there are trillions of cells that share the potential to become a reasoning human being with the mental capacity associated with humans. If the reason for protecting these cells is because they have potential to become a reasoning human being, then it follows that we would have a moral obligation to enable the cells to become a reasoning human being. This would mean that we should be assisting these trillions of cells in becoming reasoning human beings. Not many would subscribe to this plan to assist the cells in this manner, thus removing 8

weight from the theory that a one day or even five day old embryo must be

protected and nurtured to full potential and capacity (Siegel 2013). Thus, linking

moral rights of the embryo to its ultimate capacity and potential is not a strong

position.

IV. Objection: Discarded Embryos

Further evaluation of the reasons for the existence of extra or spare embryos

indicates that many come into being after fertility treatment. There are several

options available to participants involved in fertility treatment, at the conclusion of

the treatment, individuals may opt to store embryos for their own use in future

pregnancies or donate them or discard them. A donation could take the form of

wanting them to be used to help another infertile couple, or wanting them to be

used for research purposes (Siegel 2013). Pro‐life supporters and opponents of

embryonic stem cell research would only opt for storage of the embryos for future

reproductive use, as the only morally permissible use of such embryos. Pro‐life groups denounce using the embryos in research, as they believe it is akin to destroying a human in their embryonic state as noted previously.

V. Counterargument: Donate Discarded Embryos for Research

It can be argued that as long as the decision to donate embryos for research is made after the decision to dispose of or discard them, then it is morally permissible to use them in embryonic stem cell research. This argument is based on the idea that the research endeavor is not causing the death of the embryo when it was already marked for disposal. Instead, this is the morally permissible concept that the embryo already slated for destruction is being put to good use, with the potential to 9

improve the health and well being of many. Pro‐choice supporters would see donation of embryos as an inherent donor right, where donors exercise control over all aspects of their body parts. These embryos are leftover from in vitro fertilization procedures and would essentially be destroyed in any event; thus, they could be put to use for the greater good in ways to advance human health. In this case, the research effort may dictate the manner of death, but the research effort did not make the determination to destroy the embryo (Robertson 195).

VI. Impact of Ethics on Research Funding

In addition to many of the ethical arguments, debate over funding of embryonic stem cell research is very much present in the political and governmental environment. Ethics and funding have fueled the debate over embryonic stem cell research more so than actual law. A few states have banned embryo research, but largely, the debate is over administrative policy and funding, with the courts playing only a very minor role. While the Supreme Court has ruled on abortion cases, and determined that a fetus is not a person with the rights granted by the 14th Amendment, the Court has never ruled on the constitutional status of embryos outside of the body (Robertson 192).

However, human embryonic stem cell research came to the forefront of national policy with President Bush placing restrictions on this research funding in 2001. This was the first time that a US President had made the scientific method of stem cell research a topic within a major public speech addressed to the country (Lomax and Peckman 299). His administration provided federal funding for only currently existing stem cell lines, where the embryonic stem cell lines had already been derived. Additionally, funding was only provided where the research would not destroy the embryos. Federal funding was not 10

provided for not-yet-existing lines, but private funding could be used for this purpose.

Stem cell research projects were undertaken at the time, but the limitations placed on the

stem cell lines and funding policies hampered the research (Robertson 195). For example,

in many instances, the lines that could be used were not readily available nor did they

provide the genetic differences needed. There was even a question of possible infection

and contamination with these lines as they had been cultured using mouse feeder cells.

Limits on federal funding also caused problems within the laboratories that received both

federal and private funding, because they were required to physically separate sections of

the lab based on funding sources (Robertson 195). In the next few presidential elections,

stem cell funding was a prominent issue but nothing significantly changed until Barack

Obama took office. In 2009, President Obama's administration allowed federal funding of

embryonic stem cell research on new lines to go forward, to include not-yet-existing

lines, which signaled support for the scientific community of stem cell research.

VII. Ethics of Protecting Donors

There are also policies and laws protecting research subjects and their biological tissue. The US Food and Drug Administration as well as the US Department of Health and Human Services have put into effect policies that are designed to protect research subjects involved in embryonic as well as pluripotent stem cell research studies.

Opponents of stem cell research bring up the issue of autonomy, confidentiality and privacy of cell donors as a major concern. In this case, ethical considerations have provided for the protection of the donor through informed consent and various mechanisms that protect identity. Donors should know that their biological tissue may be used for future research that is unknown at the present time. Donors also need to give 11 consent for unrestricted use of their biological sample; it is not possible to predict all future uses of the samples, as this is the nature of the unknowns of scientific research.

Donors should also have the option to opt out of the research project, and be informed as to what point it is feasible to remove their biological samples from the study (Lomax and

Peckman 300-301). For example, a donor may want to remove their embryo from the study, which would be feasible up until the point that the stem cells are removed. Policies are also put in place to minimize the risk that the donor's identity is compromised. Risk reduction involves mechanisms such as collecting anonymous tissue, or removing identifiers from tissues, or creating sophisticated double and triple coding of biological materials that will allow identifiers to be securely and confidentially linked to the donor without inappropriate disclosure of identity (Lomax and Peckman 300-301). These are some of the ways that the ethical considerations of stem cell research have influenced federal policies enacted to ensure that donors are offered protections for their autonomy, confidentiality and privacy.

VIII. Conclusions

Embryonic stem cell research is fraught with ethical controversy on many levels.

Opponents of embryonic stem cell research argue that a human life is taken in the name of science. Supporters look to the life saving potential of embryonic stem cell research in developing cures and treatments for critical and life-threatening diseases, saving many lives with one embryo. The potential to eradicate blindness, spinal cord injuries and

Parkinson's Disease are just a few of the possible outcomes from embryonic stem cell research efforts. Embryonic stem cells are powerful, with the ability to regenerate and renew cells, tissues and even organs. The verdict reached thus far indicates that medical 12 breakthroughs and life saving therapies are more prevalent and are more likely to be achieved through the use of embryonic stem cell research and not through adult stem cell research. Scientists and researchers must conduct their studies responsibly, whereby the donors and their biological samples are offered protections necessary to safeguard the process. Responsible stem cell research is ethically permissible, and should be continued in both arenas, that of embryonic stem cells and that of adult stem cells to reap the most potential and save the most lives from the ravages of disease and disability.

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Works Cited:

Brignier, Anne C., and Alan M. Gewirtz. "Embryonic and Adult Stem Cell Therapy."

Journal of Allergy and Clinical Immunology 125.2 (2010): S336-S344.

Curzer, Howard. "The Ethics of Embryonic Stem Cell Research." Journal of Medicine &

Philosophy 29.5 (2004): 533-62.

Greene, Nicholas D. E., and Andrew J. Copp. "Development of the Vertebrate Central

Nervous System: Formation of the Neural Tube." Prenatal diagnosis 29.4 (2009):

303-11.

Lomax, Geoffrey P., and Steven R. Peckman. “Stem Cell Policy Exceptionalism: Proceed

with Caution.” Stem Cell Reviews and Reports 8.2 (2012): 299-304.

Louis, Mary. "Stem Cell Basics." 2009.Web. National Institutes of Health.

.

Mellor, David J., and Tamara J. Diesch. "Onset of Sentience: The Potential for Suffering

in Fetal and Newborn Farm Animals." Applied Animal Behaviour Science 100.1–2

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Monk, Jonathan. "Stem Cell Engineering 101." Chemical Engineering Progress 106.11

(2010): 35-36.

Robertson, John A. "Embryo Stem Cell Research: Ten Years of Controversy." The

Journal of Law, Medicine, and Ethics 38.2 (2010): 191-203. 14

Siegel, Andrew, "Ethics of Stem Cell Research", The Stanford Encyclopedia of

Philosophy (Spring 2013 Edition), Edward N. Zalta (ed.),

.